338 research outputs found
Experiences of disabled women during pregnancy, childbirth and early parenting services: implications for occupational therapy
The aim of this study was to understand the experiences
of women with physical and sensory disability during their
interaction with maternity services. The study was funded by a
national charity whose previous research identified that disabled
women had more negative experiences than non-disabled
women (Birthrights, 2013). This paper specifically discusses
implications for occupational therapy.
Two-phase, inter-professional mixed methods research
was used involving online surveys in phase 1 and narrative
interviews in phase 2. Recruitment was through disability
and parenting networks and social media. Survey data were
analysed descriptively and open questions were themed. Phase 2
telephone interviews were audio recorded, transcribed verbatim
and analysed thematically.
Although overall satisfaction with care was scored highly in
phase 1, negative experiences were described. Key challenges
included a lack of continuity of carer; women feeling that
they were not being listened to; feeling they were treated less
favourably because of disability; and 56% feeling that maternity
care providers did not have appropriate attitudes to disability.
Interview themes echoed these, when women described
implications of not being listened to, including that their
judgement about their own bodies was ignored or undermined.
The research revealed that occupational therapists did
little to support women during this time. While some
occupational therapy input was described, this focused on
equipment provision. Minimal support with the occupations
of parenting was described. The results suggest a clear need
for interprofessional working and the need for occupational
therapists to liaise between midwifery staff and disabled women
Urological referral of asymptomatic men in general practice in England
The Prostate Cancer Risk Management Programme (PCRMP) launched in November 2002 provides guidelines for general practitioners (GPs) on age-specific prostate-specific antigen (PSA) cutoff levels in asymptomatic men. The impact of the PCRMP on GP referrals is unknown. This study investigates whether there was a change in the proportion of asymptomatic men with raised PSA levels (⩾3 ng ml−1) who were referred to urologists since the launch of the guidelines. Sixty-nine general practices in four areas of England and the main pathology laboratory in each area, which had participated in our previous research, were asked to provide data. Forty-eight practices (70%) provided retrospective data on urological referrals in men who had a PSA test taken in the periods 1 December 2001 to 31 May 2002 (pre-launch) and 1 December 2003 to 31 May 2004 (post-launch). Data on referrals were completed for 709 (79%) out of 898 and 1040 (90%) out of 1157 raised records pre- and post-launch, respectively. The percentage of men with raised PSA levels who were asymptomatic was similar in both time periods (19–20%) and the proportion referred to urologists according to the PCRMP guidelines did not increase significantly over time (24% pre-launch and 29% post-launch, P=0.42). The referral rate was lower than expected if the guidelines had been followed. The influence of the guidelines seems to have been low. At the time of data collection, 56% (112 out of 200) of GP partners reported that they were aware of receiving the PCRMP pack. To ensure future, effective implementation of guidelines requires evaluation
The value of allied health professional research engagement on healthcare performance: a systematic review
Background
Existing evidence suggests that clinician and organisation engagement in research can improve healthcare performance. However, current evidence has considered the relationship across all healthcare professions collectively. With the increase in allied health professional (AHP) clinical academic and research activity, it is imperative for healthcare organisations, leaders and managers to understand research engagement within these specific clinical fields. This systematic review aims to examine the value of research engagement by allied health professionals and organisations on healthcare performance.
Methods
This systematic review had a two-stage search strategy. Firstly, the papers from a previous systematic review examining the effect of research engagement in healthcare were screened to identify relevant papers published pre-2012. Secondly, a multi-database search was used to update the previous review but with a specific focus on allied health to identify publications from 2012 to date. Studies which explored the value of allied health research engagement on healthcare performance were included. All stages of the review were conducted by two reviewers independently, plus documented discussions with the wider research team when discrepancies occurred. Each study was assessed using the appropriate critical appraisal tool developed by the Joanna Briggs Institute.
Results
Twenty-two studies were included, of which six were ranked as high importance. This sample comprised mixed research designs. Overall, the findings indicated positive improvements in processes of care. The review also identified the most common mechanisms which may link research engagement with improvements to processes of care.
Conclusion
This landmark review is the first benchmark of evidence that explicitly shows improved processes of care and outcomes from AHP research engagement. The lack of transparent reporting of AHP research engagement highlights the need for clear recommendations in the design of future prospective studies. These proposals specifically include greater transparency in relation to AHP involvement, mechanisms and types of research engagement. The inclusion of these aspects as an integral component of future intervention study designs may contribute essential evidence of the value and impact of AHP research engagement
Prevention and early detection of prostate cancer
This Review was sponsored and funded by the International Society of Cancer Prevention (ISCaP), the European Association of Urology (EAU), the National Cancer Institute, USA (NCI) (grant number 1R13CA171707-01), Prostate Cancer UK, Cancer Research UK (CRUK) (grant number C569/A16477), and the Association for International Cancer Research (AICR
Breast cancer and childhood anthropometry: emerging hypotheses?
In this issue of Breast Cancer Research, Baer and colleagues report a strong protective effect of childhood and adolescent body fatness on premenopausal breast cancer risk based on a large prospective study. Methodological issues are discussed, as are tentative biological interpretations regarding the findings
Pancreatic cancer in type 1 and young-onset diabetes: systematic review and meta-analysis
We conducted a systematic review of the risk of pancreatic cancer in people with type I and young-onset diabetes. In three cohort and six case–control studies, the relative risk for pancreatic cancer in people with (vs without) diabetes was 2.00 (95% confidence interval 1.37–3.01) based on 39 cases with diabetes
Blood pressure and risk of renal cell carcinoma in the European prospective investigation into cancer and nutrition.
Elevated blood pressure has been implicated as a risk factor for renal cell carcinoma (RCC), but prospective studies were confined to men and did not consider the effect of antihypertensive medication. The authors examined the relation among blood pressure, antihypertensive medication, and RCC in the European Prospective Investigation into Cancer and Nutrition (EPIC). Blood pressure was measured in 296,638 women and men, recruited in eight European countries during 1992-1998, 254,935 of whom provided information on antihypertensive medication. During a mean follow-up of 6.2 years, 250 cases of RCC were identified. Blood pressure was independently associated with risk of RCC. The relative risks for the highest versus the lowest category of systolic (>/=160 mmHg vs. /=100 mmHg vs. <80 mmHg) blood pressures were 2.48 (95% confidence interval: 1.53, 4.02) and 2.34 (95% confidence interval: 1.54, 3.55). Risk estimates did not significantly differ according to sex or use of antihypertensive medication. Individuals taking antihypertensive drugs were not at a significantly increased risk unless blood pressure was poorly controlled. These results support the hypothesis that hypertension, rather than its medications, increases the risk of RCC in both sexes, while effective blood pressure control may lower the risk. Udgivelsesdato: 2008-Feb-1
Prospective study design and data analysis in UK Biobank
Population-based prospective studies, such as UK Biobank, are valuable for generating and testing hypotheses about the potential causes of human disease. We describe how UK Biobank's study design, data access policies, and approaches to statistical analysis can help to minimize error and improve the interpretability of research findings, with implications for other population-based prospective studies being established worldwide.</p
- …